NICE

New guidance issued by the National Institute for Health and Clinical Excellence (NICE) in England and Wales has recommended the use of Aggrenox®/Asasantin®, modified release dipyridamole with acetylsalicylic acid (ASA) as first-line treatment in patients who have suffered a stroke or transient ischaemic attack (TIA) for a period of two years from the most recent event.

As part of the prevention of occlusive vascular events, the NICE guidance stated that for all stroke and TIA patients²:

• The combination of modified-release dipyridamole and ASA is recommended for people who have had an ischaemic stroke or transient ischaemic attack for a period of 2 year from the most recent event. Thereafter, or if modified-release dipyridamole is not tolerated, preventive therapy should revert to standard care (including long-term treatment with low dose ASA).
• Clopidogrel alone (with its licenced indications) is recommended for people who are intolerant of low-dose ASA and either have experienced an occlusive vascular event or have symptomatic peripheral arterial disease.

Following a first stroke or TIA patients are more likely to suffer a subsequent stroke than other vascular events due to degenerative processes in the wall of blood vessels supplying the brain. Other treatments used to reduce the risk of recurrent stroke work by inhibiting platelet aggregation and thrombus formation.

Aggrenox®/Asasantin®, however, is believed to possess multiple mechanisms of actions and additional pharmacological properties beyond the antiplatelet effect and may confer protective antithrombotic activity at the vessel wall with additional benefits for reducing the risk of recurrent stroke - over those seen with ASA alone.